Are Pap Smear Tests Annual or Not?

We are all too familiar with our annual pap smear test process, so familiar that most of us are used to never getting a call back to say "everything is okay"!  I'm sure most of us can remember our very first pap, and wish to God that we could forget ;)  I began getting pap smears when I was 14 years old, due to a severe allergic reaction I had to Tide laundry detergent, but little did I know, that this procedure would continue to be a major part of the rest of my life!  Initially, I was never told the exact reasons for pap smear tests, or what the pap smear test process actually entailed, besides the obvious of being placed in a very uncomfortable position in a cold room.  Today, I would like to take the time to explain the purpose of the pap smear test, how they should be done, and discuss a few new developments related to our annual pap smear test.

What is a pap smear test?
Well, pap is short for Papanicolaou, and Papanicolaou happens to be the last name of the doctor (George Papanicolaou) who introduced the smearing of bodily secretions onto glass slides to be read under a microscope to detect abnormal cells.  So, pap smear is basically a cervical smear, where a sample of secretions and superficial cells are taken from one's cervix, uterus, and vagina and smeared onto a slide where your doctor can view such sample under a microscope during your visit to detect bacterial over-growths, under-growths, etc.  This is significant because it enables your doctor to prescribe medication on the spot for whichever issue you are having.  After the initial microscopic visual, your samples are mailed to a lab that analyzes the specimen sample further for cellular abnormalities.  This in depth analysis can take anywhere from 1-3 weeks, at which point your doctor will contact you if your results are concerning.

The process
The process includes:

• Undressing and wearing that gorgeous paper gown ;)
• No matter which doctor I see for paps, I am always asked "have you given birth?", this question is like the prerequisite or cue for the technician to pull out the larger than small speculum
• Your doctor lubricates the speculum, and inserts it into your vagina.  The speculum expands, opening your vagina enough to give the doctor a clear view to your cervix.
• A small stick or brush is inserted to collect cells from the outside and inside of your cervix
• These cells are then placed onto a slide, and packaged properly to be mailed off to the lab
• Most doctors will then insert their fingers and palpated (to feel for or touch) your reproductive organs
• During this visit breast exams are also done

Below you will find a few pictures showing the microscopic view of pap smear slides:

A picture of a yeast infection under a microscope

A picture of bacterial vaginosis under a microscope

A picture of cervical cancer

A picture of cervical cancer under a microscope

A picture of cervical trichomonas under a microscope

Normal cervix vs. Abnormal cervix

Normal cells vs. Abnormal cells under a microscope

Why should I get a pap smear test?

Pap smears are one of the most reliable and effective cervical cancer screening tests available.  Pap smears are important as they detect precancerous and cancerous cells on our cervix, and with proper detection such cells can be treated prior to becoming cancerous, and in other cases these cells can be treated in order to prevent death.  In other words, pap smear tests serve as our yearly cervical cancer screening, as well as the yearly screening of our reproductive organs.  However, pap smear tests do not detect ovarian, uterine, vaginal, or vulvar cancers.  So, it's important to know your body and report any signs or symptoms outside of your norm to your doctor.

Here are a few pictures of the cervix in different health stages.

Stages of Cervical Cancer

Healthy Cervix

Parts of our reproductive organs

Cervix with Chlamydia

Cervix with Trichomoniasis

Cervix with Yeast

Are there any cases where a woman does not need a pap smear test?
There are a few cases where pap smears may not be needed any longer, and those cases are when your doctor states that you no longer need pap smears, AND

• You are older than 65 years of age and your past several pap smears have been normal or
• If you have had your cervix removed as a part of a total hysterectomy for non-cancerous conditions

What are the best timeframes for getting pap smear tests?

• You should start getting pap smears at the age of 21, and it's recommended up until the age of 65
• If you are 30 years of age or older it is recommended that you also get an HPV(human papillomavirus) test along with your pap smear.  HPV is a virus that exists in numerous strands, and can cause cellular changes in/on your cervix
• Depending on your age, and past pap smear results, your doctor may opt to lengthen the number of years in between your pap smear tests.  For example, if 
• You are between the ages of 21 and 29, your doctor may suggest that you get a pap smear every 3 years or
• You are between the ages of 30 and 64, your doctor may suggest that you get co-testing (pap smear test and HPV test) every 5 years, or a pap smear test alone every 3 years.
• Be certain to follow your doctor's recommendations as it pertains to your pap smear test regimen
• When preparing for your pap smear test, you should not
• Douche, or rinse vagina with water or any other fluid
• Use tampons
• Have sex
• Use any type of birth control foam, cream, or jelly
• Use medication creams in your vagina

What are "false positives, and false negatives"?

Because nothing is perfect, there are cases where your pap smear test results can be erroneous.  To be specific, most pap smear test errors fall into one of two categories being false positives or false negatives.  So, if you have heard or hear your doctor say that your results presented as a false positive, there is no problem, as the test accidentally showed you having abnormal cells when in fact they were normal.  On the flip side, if you have heard or hear your doctor say that your results presented as a false negative, there is a potential problem, as the test accidentally showed your cells as normal when in fact they are abnormal.  False negatives tend to prolong the treatment of cervical cancer, but with continuous pap smear tests and being in tune with your body, the cells will be discovered.  This speaks to how very important it is for everyone to be in tune with their body.  The smallest deviation from your normal feelings, discharge, cramping, moods, bloating, smell, etc. can be your body's way of communicating to you that something is changing and it needs to addressed with your doctor.

What does an "abnormal" pap smear result mean?

Hearing that your pap smear results returned as abnormal can be very nerve wrecking, which is why it is important to remember that an abnormal result does not always mean cancer.  In fact, an abnormal pap smear could be due to any small change on/in the cervix, such as your cervix changing due to being pregnant.  Throughout my entire life, I have had normal pap smears, except once, when I visited my doctor because I had begun to feel different along with sharp pains, cramping, and I thought I was pregnant.  I visited my doctor, a pap smear was done and samples were mailed away.  Close to a week later my doctor called me to say that my pap smear had returned as abnormal, and I needed to come to her office so she could take a biopsy.  My initial feeling was to see another OB/GYN for a second opinion before I had a biopsy done, and long story short, my abnormal results turned into our 6 year old son ;)  So, something as simple as pregnancy, or a yeast infection can cause cell changes on/in your cervix, but it is our job to know our body and to follow our gut feelings as the regimen for handling an abnormal pap smear is being created.  

When your results are abnormal, your doctor could decide to retest you immediately, in 6 months, or in 1 year, and order additional tests to go along with the pap smear.  Keep in mind that some abnormal cells have the potential to become cancerous, and your treatment regimen moving forward to address the abnormal cells should be discussed with you doctor.

New developments related to pap smears...

In 2012, new pap smear recommendations were introduced, and they stated that yearly pap smear tests are no longer recommended for patients with a low-risk of getting cervical cancer.  This recommendation stemmed from the fact that overuse of pap smear tests could cause more harm leading to unnecessary testing and medical procedures for women.  Based off of the aforementioned information, the American College of Obstetricians and Gynecologists along with the American Society for Colposcopy and Cervical Pathologists initiated new guidelines for screening women with a low-risk of getting cervical cancer, and these new guidelines are:

• Women below age 21: No Pap or HPV screening.
• Women ages 21 to 29: Pap every three years; no HPV testing.
• Women ages 30 to 65: Pap with HPV every five years (preferred) or Pap alone every three years.
• Women after age 65: Discontinue Pap screening.

Some may regard these recommendations as having economic motives, but over time we will be able to see if in fact these recommendations are truly evidence based practices.  I wanted to bring these new guidelines to light, as it would be very concerning to me if all of a sudden my OB/GYN were to tell me that I no longer needed annual pap smears, as annual pap smears have been ingrained in our life-styles and health regimens for such a significant amount of time.  I would not take it easily, and I would need data and information to help get me on the same page as the recommendations.  I have included a few sites for your viewing:

• The Society for Lower Genital Tract Disorders
• New Cervical Cancer Screening Guidelines
• Cervical Cancer Power Point
• Cervical Cancer Screening Guidelines Report

Also, keep in mind that we are all built differently, and our bodies respond differently.  With that being said, your OB/GYN will evaluate your candidacy for following the new pap smear guidelines by taking your past and current health status, your life-style, your pap smear history, your age, etc. into consideration to verify that the new guidelines are for you.  It looks like we will have to see how these guidelines play out with respect to efficiently and effectively discovering cervical cancer.  What are your thoughts?

Food Choices for Crohn's Disease

Having to figure out the foods that work for your body after a Crohn's disease diagnosis can be very time consuming and painful.  Fortunately, I have already completed some trial and error research for you ;)  The list below contains a few items that I have found to work for my body during a flare as well as on non-flare days.  The list includes:

• Yogurt with active Lactobacillus strains
• chemically broken down milk or fermented milk
• during the fermentation process, the good bacteria digests a majority of the lactose found in milk, giving yogurt the ability to avoid the element of lactose, while still being nutritional
• the good bacteria found in yogurt reside in our stomachs and over-crowd the bad bacteria in our stomachs, leading to a very healthy equilibrium for our stomach lining and immune system
• ultimately, it provides the body with much needed calories and calcium that may be lacking due to the Crohn's disease process, along with aiding in intestinal recovery
• Salmon, Tuna, and Herring
• contains Omega-3 fatty acids
• have anti-inflammatory properties
• help reduce inflammation
• Cooked carrots (should be cooked until soft and tender)
• contain antioxidants
• nutrient filled (excellent source of fiber, vitamin A, vitamin K, and manganese)
• easily digested
• Unsweetened apple sauce
• can serve as a substitute for fresh fruits and vegetables, as fresh produce can prove to be troublesome for some
• Cheese, specifically Swiss and Cheddar
• great source of calcium
• Potatoes and bananas
• exclude the potato skins (can be too high in fiber)
• great source of potassium
• helps maintain fluid body balance
• Refined cereals
• such as Cream of Wheat, Special K, Corn Flakes, or Rice Krispies
• has a small amount of fiber
• helps maintain nutritional balance
• Liquid meals
• such as Ensure
• large amount of calories in a very digestible form
• helps boost energy level, and immune system
• available in numerous flavors for the fickle taste palettes
• available for multiple nutritional needs, such as high protein or weight gain formulas
• contains dairy, so it can aggravate Crohn's symptoms in some

I have also compiled a list of items to avoid, which include:

• Spicy foods
• mild herbs and citrus juice can be substituted for spicy seasonings
• Fried and greasy foods
• the fat in these foods are not absorbed properly by the small intestine, which causes cramping and loose stools
• try foods that are baked, broiled, or steamed
• High-fiber foods
• not digested completely by the small intestine
• substitute with refined breads and pastas
• Foods with gluten
• labeled "whole-grain" or "whole-wheat"
• some with Crohn's may also be "gluten intolerant" or "gluten sensitive"
• Caffeine
• avoid if you are experiencing diarrhea, as it stimulates the intestine increasing diarrhea
• to get needed fluids try drinking water, sport drinks, and fruit juice (may need to be diluted with water)
• sip your drinks instead of gulping, as gulping can lead to excess gas
• Alcohol
• may exacerbate diarrhea
• has the potential to dry out your body (cause dehydration) and prevent proper rehydration
• has the potential to negatively interact with Crohn's medication
• Raw fruits and vegetables
• in their pure form are loaded with fiber
• not completely digested in the small intestine, causing diarrhea
• switch to cooked vegetables and fruit without skin
• broccoli, cauliflower, and beans may never make the "ok to eat" category

The key to developing a diet that helps your Crohn's disease symptoms is to keep a food diary.  This will enable you to look back at your meals to pinpoint the causes of flares or pain occurrences.  It is very important to take supplements (Omega-3s, multi-vitamin, etc.) in order to make up for the nutrients missed by removing certain foods from your diet.  Also keep an eye out for your body's response to dairy products, as they can be hard to digest and they contain lactose (causes additional aggravation for those that are also lactose intolerant).  Please keep in mind that food tolerability as it pertains to Crohn's disease is different for everyone.  So, this is just a foundation for you to try in order to discover what will work for you.  This is all I have compiled to date, so feel free to comment or ask questions.  Also, make sure you stay updated with new blog postings by selecting one of the methods located on the right menu bar.  Hope to hear from you ;)

Are tampons making us SICK...literally?

This is such a valid question, as of 6 years ago I finally listened to my body and switched to organic cotton and chlorine free tampons and sanitary napkins!  I know you are probably thinking "organic cotton and chlorine free...is it really that serious?  I'll let you be the judge...

There would come a point during EVERY one of my menstrual cycles where I would experience pain, discomfort, and almost a burning sensation when a tampon was inserted or after it had been in place for a certain amount of time, and just to be clear...I change my feminine care products every two hours regardless of the care products directions or the heaviness of my flow.  I would always "fix" this issue by removing the tampon and switching to a pad for a few days, thinking I was giving my body a rest from tampons.  However, I never took the time to think about what I was actually giving my body a rest from and what my consistent discomfort actually meant!  So, when I did pay it attention I planned to begin my menstrual cycle as usual by wearing my normal tampons, and switching to an organic cotton and chlorine free tampon when the discomfort began...AND...it was like magic...the discomfort and all of its extra symptoms went away!!!??????

Now, I have to caveat this by saying that my body is very very sensitive to a number of things, including Tide laundry detergent, certain fabrics, certain bathing soaps, etc.  So, it may just be that I am very sensitive and non-organic cotton and chlorine filled tampons and sanitary napkins only cause issues for me, but with that said I stumbled across a lot of interesting information regarding the ingredients, and processing of our EVER so convenient and life-saving monthly friends.

THE RESIDENCE OF "THE TAMPON"...
For starters, tampons (or plugs, which are their French names), are placed in our vaginas which are composed of fatty tissues and glands. This area happens to be one of the most absorbent tissue areas in our bodies.  The fat tends to store chemicals, meaning whatever chemicals we place against this tissue will be stored in the fatty tissue and/or absorbed into our bloodstream!  However, even though the vagina is very absorbent it also has its own constant self cleaning process, to expel elements that are not native to or needed in that area.

THE PARTS OF "THE TAMPON"...
Tampons usually have:

• A cord - which can be made of polyester or cotton
• The body of the tampon (the cork) - which is made of a combination of cotton, rayon, and cellulose fiber

THE CHEMICAL BREAK-DOWN OF "THE TAMPON"...

• Polyester - is a synthetic fiber made from petroleum, coal, and water through a chemical reaction with alcohol and acid.  It is like a plastic cloth that doesn't absorb moisture, but will absorb oils. It is used in the lining of feminine care products, the wrappers, and in the coating of their applicators.
• Rayon - is the first semi-synthetic fiber made by man, because it is made from naturally occurring polymers or wood pulp, which are bleached white.  This chlorine bleaching process of the wood pulp creates dioxin (more about dioxin below).  Rayon also increases the absorbency of tampons which increases the incidence of toxic shock syndrome (TSS).
• Cotton - which happens to be the non-organic conventionally grown cotton, which has been sprayed by pesticides and herbicides which both happen to be carcinogens.  
• Dioxin - also known as chlorine dioxin, is used in the bleaching process of tampons and sanitary napkins.  Traces of dioxin along with other chemicals can be found in our everyday environment as well.  The FDA admits that tampons may, “theoretically generate dioxins at extremely low levels” but there is no cause for alarm.  However, the EPA says that there is NO safe level at which dioxin exposure should exist.  The EPA has also found that dioxins can cause cancer in animals, damage the immune system, and reduce fertility over long periods of time. 

HOW DO THESE CHEMICALS AFFECT THE FEMALE BODY...

• Dioxin:
• Acts as an anti-estrogen, so it interferes with...
• the development of the female body and the secondary sexual characters
• height increases in females during puberty, 
• the burning of body fat and reduction of muscle bulk,
• the stimulation of growth of the inner lining of the uterus (endometrium) during the menstrual cycle, 
• uterine growth, 
• lubrication of the vagina, 
• the thickness of the vaginal wall,
• the blood vessels to the skin,
• bone resorption and bone formation,
• protein synthesis, 
• hepatic production of binding proteins, 
• coagulation proteins (blood clotting elements) (factors II, VII, IX, X, plasminogen),
• platelet adhesiveness and increase antithrombin III (blood clotting elements),
• good cholesterol (HDL) and also triglycerides,
• the decrease of LDL (bad cholesterol) and the promotion of fat deposition,
• blood levels of estrogen and periods of sustained estrogen at low levels correlate with significant mood lowering in women.
• Considered a Persistent Organic Pollutant (POP), which slowly over time accumulates in our bodies. This pollutant is carried in the air, in our water systems, in feminine care products, most paper products we use including napkins, paper towels, tissues, make-up removal pads, toilet paper, diapers, ect. 
• The EPA’s report on carcinogens, notes dioxin as a “known human carcinogen”. Studies have shown dioxin to trigger biological responses within the body that are carcinogenic processes (cancer processes), these include gene expression, altered metabolism, altered cell growth and differentiation, as well as steroid-hormone and growth-factor transduction pathways.
• Polyester and Rayon:
• Negatively affects our fertility,
• Polyester alone off gases (expels gases) and causes skin irritation,
• Abrasive to the delicate tissues of the labia and vagina, leading to scratches and ulcerations (making these areas prone to infection and scar tissue growth),
• Rayon produces cuts and ulcerations on the cervix, and vaginal walls during insertion and removal of the tampon (making these areas prone to infection and scar tissue growth),
• Both leave microscopic fibers that affect the vaginal walls and ultimately end up in the blood stream.
• Cotton:
• The cotton we grow today uses about 2.4% of our land, but accounts for 24% of the world's insecticide market, making cotton the world's most insecticide/herbicide-heavy crop.  
• Just to place things into perspective:
• In California, five of the top nine pesticides used on cotton are cancer-causing chemicals (cyanazine, dicofol, naled, propargite and trifluralin), 
• In 1995, pesticide-contaminated runoff from cotton fields in Alabama killed 240,000 fish,
• An estimated 67 million birds are killed each year by stray pesticides. 

RUNNING A FEW NUMBERS...
Using my tampon usage numbers to calculate possible exposure to tampon related chemicals:

• I change my tampons once every 2 hours during my menstrual cycle (no matter the flow variance and during the night) = 12 tampons a day during my menstrual cycle
• My cycle usually last for about 6 days/month = 72 tampons/month = 864 tampons/year
• I will have my cycle for approximately 45 years = 38,880 tampons in my lifetime
• I will use 38,880 tampons in my lifetime
• 38,880 tampons = WAY TOO MUCH EXPOSURE TO HARMFUL ELEMENTS

Even if the exposure to these harmful elements according to the FDA are small, the individual small amounts will accumulate over a period of time in to a large amount of exposure, especially when I'm calculated to use close to 39,000 tampons in my lifetime (especially in an area where the tissue has a high absorbency rate), and that's just for the usage of tampons.  I haven't even included my usage of sanitary napkins!

WHAT IS BEING DONE TO HELP THIS SITUATION?

The FDA has stated that

• Tampons are placed through a state-of-the-art process where their dioxin content is measured, and the dioxin content of the tampons are at or below the detectable numbers, meaning the amount of dioxin in tampons are considered to be "trace" amounts, and no health risk is expected from these trace amounts.  The keyword here is EXPECTED.
• The older bleaching method for the tampon materials was one source of dioxin productivity.  However, that process is no longer being used and instead the elemental chlorine-free or totally chlorine free bleaching processes are used. These methods for purifying wood pulp are described below:
• Elemental chlorine-free bleaching refers to methods that do not use elemental chlorine gas to purify the wood pulp. These methods include the use of chlorine dioxide as the bleaching agent.  Some elemental chlorine-free bleaching processes can theoretically generate dioxins at extremely low levels, and dioxins are occasionally detected in trace amounts in mill liquid waste and pulp (a soft, wet, shapeless mass).  In practice, however, this method is considered to be dioxin free?
• Totally chlorine-free bleaching refers to the use of bleaching agents that contain no chlorine. These methods are dioxin-free, and include, for example, the use of hydrogen peroxide as the bleaching agent.
• The FDA has asked tampon manufacturers to provide information regarding their pulp purification processes and possibilities of dioxin contamination.  These test results were from independent testing facilities that placed the tampon materials under a highly technical testing process, and the detectable limit of this assay is currently approximately 0.1 to 1 parts per trillion of dioxin.  In better terms, "1 part per trillion is about the same as one teaspoon in a lake that is fifteen feet deep and a mile square"(U.S. Food and Drug Administration).  The FDA also feels that the "risk assessment indicates that this exposure is many times less than normally present in the body from other environmental sources, so small that any risk of adverse health effects is considered negligible"(Medical Devices). 

MY SOLUTION...

Before I was made aware of the information presented above, I had already switched to organic cotton and chlorine free tampons and sanitary napkins, and I thank my body for being so sensitive.  Otherwise, I may still be using non-organic cotton female products.  The tampons and sanitary napkins that I use are made by Seventh Generation, which is the company that also makes the chlorine/bleach free diapers that we used for our son's sensitive skin when he was younger. Here are a few of the Seventh Generation female products that I use.

Chlorine free ultra-thin pads with wings

Chlorine free maxi and ultra-thin with wings, and overnight pads

NEW Chlorine free pantiliners

Chlorine free maxi and ultra-thin with wings, and overnight pads

Organic cotton super-plus tampons (with or without applicator)

Organic cotton super tampons (with or without applicator)

Organic cotton regular tampons (with or without applicator)

The Seventh Generation brand is the brand that I chose due to the fact that we were already using their diapers and pull-ups, and I was familiar with the brand.  However, there are a number of other organic cotton and chlorine free female products on the market, that I'm sure work just as well.  I have included a few pictures of how these tampons look during their absorption and expansion process.  The pictures may seem a bit obsessive to some (call me obsessive...lol), but these are things that I would like to know when being introduced to a new product prior to purchasing it.

Original packaging of regular (top), and super (bottom) tampons

Tampons after removing packaging regular (top), super (bottom)

Tampons with cotton slightly pushed out of applicator regular (top), super (bottom)

Tampon cotton outside of cardboard applicator, in its original state upon insertion 

regular (top), super (bottom)

Tampon expansion about 3 seconds after insertion into a glass of water.  

WARNING, I'm not sure how fast the tampon would actually start 

absorbing/expanding upon vaginal insertion, 

as water and blood are of two different consistencies.

Expansion from the front

Expansion from a side view

Expansion from the back

Expansion held after an hour, without water leakage into the sandwich bag

Expansion from another awkward view.  You can almost see the cotton strands in this picture.

I hope this information helps keep you informed about feminine products, and please feel free to research this topic on your own and comment.  I'm positive that there is still plenty that I may not be aware of.  I have included the links that I used to gather my information below.  

• Fertility
• FDA
• FDA
• Seventh Generation
• World Health Organization
• National Research Center for Women and Families

Feel free to comment and add to the conversation, and don't forget to stay informed with my new posts by following this blog.  You can follow this blog by choosing from the "Subscribe Below" and "Follow by Email" headings located on the right menu bar ;)

Toxic Chemical Safety -Chemical Safety Improvement Act -Seventh Generation Campaign | Seventh Generation

Toxic Chemical Safety -Chemical Safety Improvement Act -Seventh Generation Campaign | Seventh Generation

Uterine Fibroids...A long kept secret for many!

For years I have known of friends and family members that have uterine fibroids.  Some women have such a complex case of uterine fibroids that they are not able to have children or they begin to look pregnant due to the excessive growth related to some uterine fibroids.  Along with causing visible bloating, uterine fibroids can inconvenience many and make social gatherings very uncomfortable.  I have had numerous friends who have to consider EXCESSIVE bleeding episodes when preparing to attend social functions.  Meaning, they need to wear dark clothing, they need to wear close to 3-4 maxi pads along with a tampon, in fear of standing up and having blood expelled profusely.  In addition to the visual symptoms, women also experience symptoms related to anemia due to the drastic and excessive amount of blood loss.

I decided to write this blog post because I have family members and friends who have been living with this medical condition and the additional medical conditions that accompany it for years.  And yet, it has never really been a topic of conversation for most, at least until recently with the presentation of a more advanced treatment for uterine fibroids.  This new treatment is called uterine artery embolization/uterine fibroid embolization.  But before we get into this specific treatment let's grasp a basic understanding of what a uterine fibroid really is.

So, what are uterine fibroids exactly?
They are benign tumors composed of smooth muscle in the uterus of women.

The uterus with uterine fibroids of different classifications 

What's their prevalence?
75% of women battle with uterine fibroids, and 50% of African American women have uterine fibroids.

Can they become cancerous?
Less than 0.1% of the fibroid tumors become malignant (or cancerous).

How do the fibroids develop?
A genetic predisposition exists, and the tumor develops from an overgrowth of smooth muscle and connective tissue in the uterus.  Both estrogen and progestin receptors are present in fibroids and elevated estrogen levels may cause fibroid enlargement.

What causes uterine fibroids?

• Genetics
• Hormones - estrogen and progesterone are two hormones that stimulate the growth of the uterine lining during each menstrual cycle in preparation for pregnancy, and promote the growth of fibroids.  Thus, fibroids tend to shrink after menopause when our hormones decrease.

What are the risk factors?

• Heredity - if your mother or sister has fibroids, you chances are increased
• Race - African American women are more likely to have fibroids.  AA women have fibroids at a younger age, and they are more likely to develop more and larger fibroids
• Size - obese women are at a higher risk of developing fibroids
• Other factors - onset of menstruation, having a diet high in red meat and low in greens and fruit.  Drinking alcohol, including beer tends to increase the risk of developing fibroids.

What should we be looking for to know if we have uterine fibroids?

• Most produce no symptoms
• Abnormal/heavy menstrual period
• Prolonged menstrual periods (7 days or more)
• Pelvic pressure or pain
• Frequent urination
• Difficulty emptying your bladder
• Constipation
• Back ache or leg pains

What size are uterine fibroids?

The size can range from the size of your thumb nail to a size so large that the woman begins to look pregnant.

The varying sizes of actual uterine fibroids

An actual very large uterine fibroid

Cynthia Bailey Before (picture on right) and After (picture on left) Uterine Artery Embolization

When should you contact your doctor?

• Pelvic pain that doesn't go away
• Overly heavy or painful periods
• Spotting or bleeding between periods
• Pain consistently during intercourse
• Enlarged uterus and abdomen
• Difficulty emptying your bladder

What can be done to relieve uterine fibroids?

• Hysterectomy - the surgical removal of the uterus.  This method can be the only effective method in some cases.
• Myomectomy - the surgical removal of the uterine fibroids from the uterus.  This method is preferred for women who would like to become pregnant.
• Laparoscopy - a surgical procedure that utilizes a laparoscope (a thin lighted tube with a camera at the end) that is inserted into the abdomen through a small incision.  The laparoscope allows the doctor to view the pelvic cavity, and other tools are inserted through the laparoscope or inserted through other small incisions in the abdomen in order to remove the fibroid
• Uterine Artery Embolization - this procedure can be performed by a radiologist, and this procedure cuts off the blood supply to the uterine fibroids, starving the fibroid thus causing shrinking.  This procedure is minimally invasive and less aggressive than the removal of the uterus.  This procedure is effective, but not recommended for women who wish to become pregnant.
• Medications - anti-estrogen medications such as progesterone, but too much progesterone can cause menopausal symptoms and osteoporosis.  Meaning, hormone therapy should not be a long-term treatment option.

Uterine Artery Embolization

• Minimally invasive
• Less aggressive
• Cuts off blood supply for fibroids, leading to fibroid shrinkage or death
• Very effective, but not for everyone.  Your doctor has to decide given your health picture, if you are a great candidate fro this procedure.  Reasons for not choosing this procedure include having:
• A history of pelvic radiation
• A history of kidney failure
• Possible pelvic cancer
• An active, recent, or chronic pelvic infection
• Poorly controlled diabetes
• Inflammation of the blood vessels
• An untreated bleeding disorder
• A severe allergy to contrast material containing iodine
• Symptom relief usually within the first three months after your procedure
• Menstruation can return within a few months after the procedure, but some women actually go into menopause after this procedure.  Studies have shown that going into menopause after this procedure is highest among women 45 years of age and older.
• The impact on fertility are due to:
• subtle ovarian damage = making getting pregnant difficult
• increased risk of pregnancy complications
• however, there is a percentage of women who have successful pregnancies after this procedure.

In a few months, one of my close relatives will be having this procedure done, and this works out well for blog participants, as I will post her progress, her biggest concerns or problems, and complications.  Also, an actor of Atlanta Housewives, Cynthia Bailey has had her own struggle with fibroids, please take some time to check out her story as well through this link Cynthia Bailey's 14 Year Struggle with Uterine Fibroids, and Cynthia Bailey's Uterine Fibroid Treatment.  Please keep in mind that your doctor should go over ones candidacy for this procedure, and once the candidate in properly informed it is then the candidates decision to proceed with the procedure.  I hope this post helps shed some light on a health condition that women cope with, but don't actually get to talk about often.  Please feel free to comment or ask questions.  Until next time...